Provider Demographics
NPI:1952532335
Name:ADVANCED PORTABLE X-RAY, LLC
Entity Type:Organization
Organization Name:ADVANCED PORTABLE X-RAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:MCGAHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-946-1087
Mailing Address - Street 1:472 FARM ROAD 2297
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-4719
Mailing Address - Country:US
Mailing Address - Phone:903-885-3200
Mailing Address - Fax:903-439-0462
Practice Address - Street 1:3718 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-2244
Practice Address - Country:US
Practice Address - Phone:903-885-3200
Practice Address - Fax:903-439-0462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier